Medical based MEQ

Q1 past yr question (GOUT)

Q3:

68 y/o smoker for 40 yrs, chest pain, SOB, initially dry cough, then blood stained mucopurulent sputum,

1. 4 Ddx

Chest x-ray

2. 4 findings

3.Pe finding

a) chest movement

b) percussion

c) vocal resonance

d) auscultation

4.Provisional dx

5. Blood urea >7.8, how to predict severity and prognosis based on parameter

6.After 3 days, suddenly develop severe respi distress, 2 possible causes

Q5 puffiness of Face, Hematuria3+, proteinuria 1+, no other symptoms, active, no previous infectiin

1) what condition is this

2) 3 causes of hematuria

3) investigation.

4) outline management

ECG(hyperacute T wave)+ reduce urine output

1) condition

2) complication of this condition

3) 2 other complication
Q6 Dengue

1. criteria NOT to admit

2. D2-3 investigation to support

3. Outline management of dengue(no warning signs)

Days later, p/w warning signs

4. Diagnosis

5. Outline management

6. Criteria to discharge

7. Environmental cause of dengue

Q7 TIA

80 years old male with u/l diabetes mellitus and hypertension p/w right UL and LL weakness. Now
complain dizziness

1. 6 history you want to take

On PE, patient hypertensive, irregularly irregular pulse, weakness resolved within 10 hours

1. 4 differential diagnosis

2. Provisional diagnosis

3. Risk factors

4. Preventive measures

Q8 Patient presented with sore throat and request for antibiotics

1. Can you describe antibiotics

Later patient claimed to have fever and running nose

2. Wat are the 4 questions u can ask

3. Wat antibiotics can u prescribe

4. Centor Criteria for sore throat

5. Possible causal organism for sore throat

6. Complications of strep infection

Q9 Pt with depressive episode, mother commit suicide 1 month ago

1. Give 3 differentials

2. 5 SAD PERSON criteria other than mentioned in statement.

3. Give 2 biological investigations.

4. Pt then develops manic episode (with hosp admission). Give most likely diagnosis.

5. 4 things to tell in informed consent of ECT

Q10

Man with pulm tb sx

Q1 is his family risk of contact by tb

2. 2 screening test for tb

3. 3 group prone to get ptb

4. Regimen for newly dx ptb

5. 3 reasons Why tb still high in malaysia

6. 4 advantageous of Dots
Surgical based MEQ

1. 35yo man pw with epigastric pain and vomiting for 5 days. Had similar attack last year. Normal bowel
habit and appetite.

a. 4 differential dx

No passing tarry stool. Frequent meals and worse at morning. No pallor and jaundice. Vital normal.
Epigastric tenderness but no mass.

b. Provisional diagnosis

c. 2 investigations

d. Outline medical management

Increasing pain with abdominal distension and rigidity.

e. Complication above?

f. How to confirm?

g. 2 surgical options

h. How to educate pt for reccurent prevention?

Question 2 (femoral hernia)

57 y/o woman, right groin lump-5days, skin is erythematous, irreducible, below and later pubic tubercle,
ultrasound dilated bowel, reduced motility.

4 ddx

Provisional diagnosis

4 supportive points

Pathophysiology

4 possible complications

3 surgical approach

4 complications of surgery

3. Obstructive jaundice

Patient presenting with sclera jaundice and pruritus for 3 months.

1. 4 ddx

Dilatation of cbd and acoustic shadow

2. Provisional diagnosis

3. Pathophysiology of pale stool and darked color urine

4. 2 investigation

5. Complication

6. Surgical intervention

5. Placenta praevia

1. Risk factors

2. Complication for fetal and mother

3. Parameters to look for in UTZ

4. Investigations

5. Treatment

6. 29y/o, G4P0+3, amenorrhea 15 weeks, per vaginal bleeding with tissue. S/E: os open with tissue
seen, blood seen in vaginal

-provisional diagnosis ; supportive evidence (3m)

History of 2 complete miscarriage and 1 incomplete miscarriage

- provisional diagnosis (1m)

- 4 probable causes (2m)

- 4 investigations (4m)

- outline mx for this patient (5m)

-Ovarian Ca (cannot remember the questions)

-Multiple pregnancy

1)extract the risk factor for multiple pregnancy from the trigger given.

2) 2 cx of twins pregnancy in maternal and fetus each

3)outline intrapartum mx

(few more questions, cannot remember)

ORTHO

Tibia and fibula fracture on POP p/w compartment syndrome

(cannot remember the first few questions)

1)xray was given

- state 2 abnormalities noted

---develop sudden pain on the fracture site . dorsiflexion causes pain.

1)dx

2)2 causes for the dx

3)2 immediate mx

-- no improvement noted

4)definitive mx

5)outline mx after sx improved

SEPTIC ARTHRITIS

9ish year old boy p/w knee swelling , erythematous , painful on touch etc

1)ddx

2)ix

3) 2 cx that can occur

(few more questions but cannot remember)